Acute bronchial asthma is a common problem with immense medical and economi
c impacts. It is estimated that this disease affects 12 to 14 million peopl
e in the United States with costs in excess of $6 billion per year. Most of
the morbidity and all of the mortality of asthma tends to be associated wi
th acute exacerbations, and treatment of these events accounts for the majo
rity of expenditures in money and health care resources. Unfortunately, the
factors that contribute to the destabilization of asthma are rarely studie
d and much of the pathogenesis and pathobiology of acute asthma remains unk
nown. This article examines these issues and suggests treatment for acute a
sthma.